| NPI | 1326451865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C BRANNON Credentialing 704-884-2060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 2932A) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |